| Author | Message | ||
     Stephentoddneal New member Username: Stephentoddneal Post Number: 2 Registered: 11-2007 |
Hello Juerg, I am working with a client that has been unable to run for some time due to hip pain. She has been to see a number of different therapists and no luck. I feel it is flexibility at the ankle which is less than 5 degrees. Hamstrings are at about 70 degrees up from 45 from stretching them as well as hip flex and quads. what is a good goal range for the ankle? Thank you and hope you and the family are well. Steve | ||
| Juerg Senior Member Username: Juerg Post Number: 2514 Registered: 04-2006 |
Interesting question but I need some more info here. There is no real normal in ankle motions, as it rather depends on running technique and actual joint play. The key in testing a joint is not only assessing ROM but assessing active and passive ROM. In the ankle you have additionally the question of knee position if you test simply the muscle range due to the soleus and the gastrocnemius interference with the first only a one joint muscle and the second a two joint muscle. So if you test you have to test with knee flexion and extension to assess , which one is the short muscle and may interfere in this case with a reduced dorsiflexion. Now 5 degrees does not tell me a lot yet . Take the international neutral zero method of joint testing . So we have a better understanding of the ROM. It would read for example. Dorsifl / PlantFlex ( 10/0/30) Now once we have this established, than we have to see the actual joint play , meaning the motion between talus and tibia ( talocrurale joint) and see, how the gliding occurs, as it could be not a muscle but a joint limitation. Next up is the joint play between fibula and tibia proximal and distal as well , as there has to be a proper joint play there as well. ( often a reason for ITB attachment problem and often overlooked as well. Than the motion in the knee and finally the symmetrical situation in the hip joint mainly assessing internal and external rotation in hip neutral zero position as well as in hip position 90 degrees flexion. If you test in 90 degrees flexion check carefully the position of the pelvic and lumbar area, as they often move into a lumbar kyphosis and therefor the rotation in the hip will change very strong. One of the most overlooked test is the IR in neutral zero hip position or even in 10 degrees hip extension , as this is the position of the take of in a run. This may be the first one you should check for asymmetric problems and than go from there. Good luck and sorry as it is very difficult to give proper info over a Forum when we can't see and test the person. Juerg | ||
| Juerg Senior Member Username: Juerg Post Number: 2515 Registered: 04-2006 |
Interesting question but I need some more info here. There is no real normal in ankle motions, as it rather depends on running technique and actual joint play. The key in testing a joint is not only assessing ROM but assessing active and passive ROM. In the ankle you have additionally the question of knee position if you test simply the muscle range due to the soleus and the gastrocnemius interference with the first only a one joint muscle and the second a two joint muscle. So if you test you have to test with knee flexion and extension to assess , which one is the short muscle and may interfere in this case with a reduced dorsiflexion. Now 5 degrees does not tell me a lot yet . Take the international neutral zero method of joint testing . So we have a better understanding of the ROM. It would read for example. Dorsifl / PlantFlex ( 10/0/30) Now once we have this established, than we have to see the actual joint play , meaning the motion between talus and tibia ( talocrurale joint) and see, how the gliding occurs, as it could be not a muscle but a joint limitation. Next up is the joint play between fibula and tibia proximal and distal as well , as there has to be a proper joint play there as well. ( often a reason for ITB attachment problem and often overlooked as well. Than the motion in the knee and finally the symmetrical situation in the hip joint mainly assessing internal and external rotation in hip neutral zero position as well as in hip position 90 degrees flexion. If you test in 90 degrees flexion check carefully the position of the pelvic and lumbar area, as they often move into a lumbar kyphosis and therefor the rotation in the hip will change very strong. One of the most overlooked test is the IR in neutral zero hip position or even in 10 degrees hip extension , as this is the position of the take of in a run. This may be the first one you should check for asymmetric problems and than go from there. Good luck and sorry as it is very difficult to give proper info over a Forum when we can't see and test the person. Juerg | ||
| Stephentoddneal New member Username: Stephentoddneal Post Number: 3 Registered: 11-2007 |
Thank you Juerg. This person has gone back to university to write exams but I will see her in about 1 week and will attempt to get better information. Steve |